Quitting cigarettes is hard. Staying clean is far more difficult.

My mind was churning, I was grinding my teeth to nubs, I tossed back and forth cursing myself for taking up a habit so hard to kick. It was the third sleepless night in a row as I teetered on delirium.

The physical effects were just beginning. I could feel my lung capacity expanding with each breath and my sense of smell began to return just enough to realize how bad I smelled. My head ached and my throat swelled from the persistent cough that started earlier that day.

Still, all I could think about was I wanted a smoke.

There can’t be anything good about something that can make you feel so horrible. That’s why more than three million Americans try to end their nicotine addiction each year, according to the U.S. Department of Health. Nobody claims it’s easy. But there are resources to improve the odds of success.

As a half-pack-a-day smoker for nearly ten years, there was no shortage of reasons for me to quit.This is not my first attempt. Yet I have a feeling this time will be different, because I really want to stop.

On the second day of 2010, I began weaning myself from cigarettes, eventually getting down to two or three a day. On Jan. 8, I passed my first full 24 hours without a cigarette in more than five years. I cleaned out my car, and threw away my lighters and ashtrays.

That’s how my journey started. How it would end—would it ever end?—I was completely unsure.

Look at the loser

The many counselors and physicians I later consulted all said repeatedly, successful quitting depends upon environment. And San Luis Obispo is hardly a fun place to be a smoker.

Aside from the daily looks of disgust from health-conscious, do-good joggers and bicyclists as I puffed away on the street corner, new city ordinances have created a downright hostile environment for smokers. SLO became the first city in the nation to ban smoking in public buildings in 1990. On Dec. 1, 2009, the city outlawed tobacco use in such outdoor public areas as parks, and made clear a city-wide public ban is just around the corner.

The American Lung Association, the leading national anti-tobacco organization, on Jan. 12 released “grades” for such anti-smoking efforts among cities within the county as Smokefree Outdoor Air, Smokefree Housing, and Reducing Sales of Tobacco. The study graded cities on an overall scale of one to 12 points: SLO and Arroyo Grande earned the highest scores—six and five, respectively—achieving C’s. Grover Beach received a D with four points, and Atascadero, Morro Bay, Paso Robles and Pismo Beach all earned F’s with just one or no points at all. SLO also scored the highest among the 10 most populous cities in the state’s central region, next to Santa Barbara.

There isn’t a smoker nationally who isn’t aware smoking is the leading cause of preventable death in the U.S. According to the National Institute on Drug Abuse (NIDA), tobacco kills roughly 440,000 Americans every year and one in five U.S. deaths are the direct result of smoking. A 2007 NIDA study found an estimated 70.9 million Americans aged 12 or older admit to using tobacco—60.1 million of which, or 24.2 percent of the population at the time, are cigarette smokers. Sound high? According to the Centers for Disease Control, the percentage of the U.S. population that smokes has dropped more that 50 percent since 1965.

Smokers know well that smoking is on its way out. Relentless efforts by anti-tobacco forces have been very effective, especially since the Tobacco Master Settlement Agreement of 1998, which obligates tobacco companies to cough up $206 billion for programs through 2025 to counter tobacco use among youths and educate consumers about preventing tobacco-related diseases. According to the NIDA’s latest Monitoring the Future survey released in Dec. 2009, the number of young smokers—the industry’s bread and butter—has dropped to the lowest point in the survey’s history with 11.2 percent of high- school seniors claiming to smoke daily, less than half of the 24.6 percent reported in 1997.

Smoking is no longer cool. A colleague recently told me whenever he sees someone puffing away, he says to himself, “Look at that loser. What a poor loser.” I don’t know why, but those words haunt me. My daily mantra is “Don’t be that poor loser.”

TAKE THESE TIPS: Plan for a change. Break smoking triggers and habits, and start healthy habits, such as exercise. Drink more water, juice, or herbal teas. Avoid beverages you associate with tobacco. Don’t overeat.

Gather support. Ask healthcare providers about free cessation programs, tell friends and family about your goal, and talk to people who have successfully quit.

Cut down slowly. Gradually cut down over a span of two weeks. Set a quit date for the third week.

Control cravings. Physical withdrawals will subside within three days, but psychological triggers will remain. When a craving hits, drink a glass of water, go for a walk, do relaxation exercises such as deep breathing, and always keep your hands busy.

Most of all, through each step in the quitting process, remind yourself why you’re quitting.

I can quit you, baby

The day before that third night of agony and despair, foreseeing trouble, I decided to take advantage of my benefits as a taxpayer and explore the free help available to anyone struggling to break free of nicotine addiction.

A quick browse online yielded the SLO County Health Department Tobacco Control Program, which offers six-week smoking cessation classes at no cost. Though seriously jonesing for a smoke, I found sharing my thoughts with the counselor in a group wasn’t as painful as I had feared. Sure, I was hoping to score the free nicotine patches or gum I heard they hand out like candy but it wasn’t as easy as that. Nothing’s easy when you’re three days without a smoke.

They didn’t let me leave my first session empty-handed, however. Jumping into the course at week two, at which point many in the class were still a week away from their quit date, I figured I was ahead of the game. Unfortunately, the way the course works is you have to go through the regimen, all six weeks, and you don’t actually quit until week three, when you can sign up to receive nicotine replacement products.

Bummed, chewing my cinnamon toothpick and clenching my clammy fists until sweat dripped from my palms as I squirmed uncomfortably in my chair, I sat in the room at the Health Dept. building in Grover Beach and focused on deep breathing.

According to Kitty Farhar, a health education specialist for the county and my new counselor, at week two it’s essential that people in the program remind themselves why they are going through the torturous process and that no matter how long they’ve smoked, they can succeed with support.

The health benefits are instant, she said, noting that within 20 minutes, the blood pressure drops back to normal; within eight hours, carbon monoxide levels in the blood decrease and oxygen increases to normal; within 48 hours, damaged nerve endings start to regrow, and taste and smell begin to return; and bronchial tubes relax after 72 hours as the last traces of nicotine leave the body.

The upside of my joining at the second week is that Farhar discussed products proven to help through nicotine replacement therapy, which reduces the cravings roughly 80 percent of smokers say are the only reason for not quitting. For example, a well-advertised brand of gum that provides a controlled amount of nicotine to the system at a slower rate than a cigarette, more than doubles the chances of quitting (18 to 30 percent) compared to going cold turkey (10 percent), according to the manufacturer’s website.

Same goes for patches. They release a steady stream of nicotine into the system through the skin and wean smokers from addiction in steps to lower doses over time. The Food and Drug Administration recommends using patches for three to five months. Nicotine lozenges are also available over the counter.

For heavier smokers, Farhar recommended such alternatives as nicotine nasal sprays, nicotine inhalers, and strong nicotine lozenges, available only by prescription. For the heaviest smokers, or addicts who’ve tried unsuccessfully to quit many times, Farhar said a relatively new product, Chantix, made by pharmaceutical manufacturer Pfizer, has a high success rate.

As I sat at a roundtable with my fellow quitters, the young woman next to me said she had gone weeks without a cigarette and credited that prescription product. Other than vivid dreams, she said she hadn’t experienced anything she’d call a side effect.

A bump in the road

On my fourth day without a cigarette, the toothpicks weren’t helping anymore. My head throbbed from laying off coffee—it always triggered the need for a cigarette, so I’d stopped drinking it—my jaw was swollen from four days of grinding teeth and chewing gum, and I just couldn’t resist: I grabbed a stashed-away pack from my car and lit up. The rush was magnificent, instantly refreshing. Instantly I regretted it.

I glared at myself in my rear-view mirror. “Look at that poor loser,” I muttered in disgust before sticking the half-smoked butt into an empty 7-Up can in the cup holder. So much for that new-car smell.

Without any gum or patches to tide me over the next time an urge to smoke hit, I called the state’s smokers’ helpline (1-800-NO-BUTTS). California provides a toll-free, over-the-phone counseling service made possible by funds from Prop. 99 and Prop. 10 tobacco taxes. The counselors I spoke with were friendly and informative, and assured me, despite my blubbering, I hadn’t screwed up. Instead, said the first voice over the phone, this was a great opportunity to identify the trigger that had set me off the path: It was stress and the five-minute drive that provided an opportunity to spark one up without being noticed. She also advised—surprise, surprise—I toss the pack from the car.

The problem with the helpline was that my first call only scheduled an appointment for that evening. If I were jonesing really badly, I would have given in by then; fortunately, the taste of the slip-up smoke lingered on my palate, hands, and conscience.

The half-hour telephone session later that night was helpful, however. Talking with my counselor, Dawn, was relaxing. Dawn, whose name I found ironic, provided me with answers to just about all of my queries, and I found talking anonymously over the phone to a stranger oddly refreshing. She seemed to be a regular person, leaving out the technical jargon for common sense suggestions.

Most important, she said, was to change my daily routine. You have to diffuse the spotlight from the missing cigarettes, she said. For example, many smokers don’t eat breakfast, instead opting for coffee and a smoke. She also suggested I bite the bullet and invest in some anti-smoking medication.

I looked into that, but myhealth insurance doesn’t cover such products. If talking with insurance agents isn’t enough to make you need a smoke, I don’t know what is. Bottom line: I can’t afford Chantix, so what else is out there? That’s when I talked to Nancy Walden.

Being fresh out of college, I figured someone at the local university would have some tips. Walden, a nurse practitioner at Cal Poly’s Health Services Department and also a certified smoking cessation specialist, sat me down and gave me the skinny on Wellbutrin, also known as Zyban.

Wellbutrin, Walden said, is an inexpensive alternative to the pricey Chantix, and can be just as effective. First used as an antidepressant at V.A. clinics, physicians discovered it also helped patients readily quit smoking. Somehow, she said, it works on the neuropathways to block cravings.

“It seems to work really well. I’ve helped a lot of people quit that way and it’s just smooth,” Walden said. “You’re on it a week before your quit date and people tell me their cravings go way down and they’re able to quit without even trying.”

After telling Walden I was going cold turkey without the use of medication, she told me I was being too hard on myself by giving up coffee and tobacco at the same time and that my headaches were from the combined lack of nicotine and caffeine. She recommended resuming coffee and using a common pain reliever to quench any further headaches.

If any smoker needs motivation to quit they should talk to a pulmonologist. According to Dr. Barry Feldman, a pulmonary specialist and director of intensive care at Marian Medical Center in Santa Maria, smokers are more than five times more likely to develop lung cancer than nonsmokers. Patients at the very first stage have a survival rate of about 80 percent after five years if treated, typically with radiation and surgery. With stage-four lung cancer, five to ten percent survive that long.

Feldman assured me my cough was natural and actually a good sign. When a person quits, he said, the cilia in the lungs, though matted in my case by 10 years of tar, begin to grow back and the body tries to rid itself of the gunk. Unfortunately, while the lungs may slowly heal themselves, a former smoker will always have a high risk of developingpulmonary illness.

I asked the doc straight up: At what point do you tell a patient that if they don’t stop smoking, they will die? “I tell them the very day I meet them,” Feldman gravely emphasized.

USE THESE RESOURCES: Your healthcare provider can help with a quit plan and get you in touch with local stop-smoking programs.

Your local health department: Most counties provide smoking cessation groups for support and information. In SLO County, the Public Health Department has a Tobacco Control Program with groups meeting once a week. For more information, call 805-781-5564.

Telephone support sessions: The California Smoker’s Helpline is a free service funded by the California Department of Health offering one-on-one counseling.

National organizations can provide quitting materials and referrals. Call American Lung Association at1-800-LUNG-USA and National Cancer Institute’s cancer information service at 1-800-4-CANCER.

Without cessation aids beyond the toothpicks to brace my fall, I found myself still craving a smoke at every sip of coffee, every workday commute. At two days without a cigarette, the physical cravings again began to subside, but getting the idea that I want a cigarette out of my head remained the biggest challenge. The body may kick the habit, but how do you get the mind to catch up?

Enter Harvey Hunt. Hunt has been a hypnotherapist more than 40 years and is a certified member of the National Guild of Hypnotists. The Templeton-based Hunt specializes in helping people overcome habits and problems from nicotine addiction to depression to nail-biting.

According to Hunt, hypnotism doesn’t “put you under” like in the movies. Instead, he said, hypnotism works by encouraging acceptance of a suggestion.

“The conscious and the subconscious mind don’t communicate with each other,” Hunt explained. “When you’re learning to do something consciously you have to work on it. Once you’ve learned it comfortably, it goes into your subconscious. That’s where things like smoking and other habits go and that’s where many fears and phobias come from. But with hypnosis you can now communicate with that subconscious mind.”

“No one ever took a second cigarette because the first one tasted good. That’s an indication of how powerful the subconscious is,” Hunt said. “It wants to fit in so badly that it will take the second cigarette no matter how bad it tastes. That’s the reality of it. If we take the subconscious and turn it around to work for you, then that’s a lot of power,” he explained.

As I worked overtime to fathom what Hunt was saying, he suddenly shuffled the small stack of papers with his right hand in an overly exaggerated motion. Of course, my eyes instantly clung to the shuffling and he sat up and pointed to me and said with a grin, “See how easy it is to bypass your critical thinking, even for a moment?” I guess he had me there. But how does he keep your mind occupied for a prolonged period of time? “Well, maybe I should just show you,” he said.

Standing with my eyes closed and arms at my sides, I became strangely relaxed, though I remained keenly aware I was in a New Times office being watched by coworkers. Hunt, standing at arm’s length, and speaking slowly and coolly like David Carradine in Kung Fu, walked me through a number of mental scenarios, repeating in between, “I’m a nonsmoker. I am in control.”

As the session progressed, the confidence in my voice while repeating this mantra grew stronger. I could hear it. Hunt had me imagine working hard, as I had done only days before, on thoroughly cleaning out the inside of my car. After I finished that imaginary task, Hunt told me to sit still and breathe in the new car smell I rediscovered. Then he had me imagine lighting up a smoke inside the car, obliterating all the work. I felt a little sick.

Another scenario he evoked was walking into the corporate headquarters of my cigarette brand and taking the elevator to the office of the CEO. There, I tell the pompous, cigar-sucking fat cat wearing a pin-striped suit that he’ll never get another dime from me. Elated, I take the elevator to the lobby while repeating, “I’m a nonsmoker. I am in control.”

After 20 minutes of such hypotheticals, Hunt snapped his fingers and I opened my eyes. For the first time since starting this whole process, I found the thought of smoking repellant. And I can’t explain it but my lungs actually felt good. The last thing I wanted to do was smoke.

Asked how successful hypnotherapy is to kick smoking, Hunt said look at it two ways. When people leave his office, he said, it’s 100 percent effective. Hunt said he’s never had anyone tell him they still wanted a cigarette when they leave his office but when he checks up later, he figures 80 percent are still smoke-free.

I spent most of that day feeling uncharacteristically optimistic and believing I’d become a nonsmoker. Those feelings didn’t last, but when cravings returned that evening, they seemed a little easier to ignore. The effectiveness of hypnotherapy varies from person to person, but Hunt maintained it could be the deal-sealer for anyone who truly wants to quit.

And for the kicker

Quitting was hard. Staying quit will be much harder.

There’s no one resource, tip, or strategy to thank for my success so far, but my recommendation is, take in a bit of all that’s out there and you’re bound to find something that works. Above all, call the helpline. As Walden and Farhar both said, it’s easy to get overwhelmed by the fact that quitting is a major lifestyle adjustment. Take the process one day at a time and the decision will last a lifetime.

So as I continue life as a former smoker, two days without a cigarette, I’m savoring my achievement knowing, though congratulations would be premature, that I am doing the best thing I can to improve my health and fitness.

Staff writer Matt Fountain can be reached at mfountain@newtimesslo.com